BSA MERIT BADGE UNIVERSITY

Application for Admission & Registration Form

I HEREBY APPLY FOR ADMISSION TO THE BASS PRO MERIT BADGE UNIVERSITY FOR THE 2004 SESSION. SEE SIGN UP FLYER FOR CLASS OFFERINGS. NOT ALL BADGES ARE OFFERED AT THE SAME TIME!

Name: _____________________________________________________________

Address: ___________________________________________________________

___________________________________________________________________

Troop#: _________ Phone#: ____________ Age: ___________ Rank: ___________

Please enroll me in the following: (indicate 1^st, 2^nd, 3^rd Choice.)

Fingerprinting ______________ Archery _____________

Aviation ______________ Climbing _____________

Leatherwork ______________ Orienteering _____________

Soil and Water ______________ Wilderness Survival _____________

Conservation ______________

I agree to complete all prerequisites prior to arrival. I will bring my completed prerequisite form, properly filled and signed by my scoutmaster. I understand that failure to complete all requirements will make me ineligible for participation in the Merit Badge University.

Signature of Applicant __________________________________________________

Approval Signature of Parent or Guardian

____________________________________________ Date: ___________________

PLEASE PROVIDE AN EMAIL ADDRESS WHERE YOUR NOTIFICATION OF ACCEPTANCE CAN BE SENT. NO PAPER COPIES WILL BE MAILED. THANK YOU.

EMAIL ________________________________________________________________